
This study investigates the spatial variation in HIV/AIDS prevalence and treatment coverage across Niger State Local Government Areas (LGAs) of a selected region using a Geographic Information System (GIS)-based spatial analysis approach. The aim was to uncover geographic disparities in infection rates, testing outcomes, and antiretroviral therapy (ART) enrolment, thereby providing a spatially-informed framework for targeted intervention. Epidemiological data, disaggregated by gender, age, and testing status, were integrated with spatial boundary datasets in ArcGIS 10.2.1 to produce thematic maps reflecting HIV-positive and HIV-negative distributions, as well as ART uptake. The findings revealed a clear spatial heterogeneity in HIV/AIDS prevalence, with LGAs such as Kontagora, Paiko, Suleja, and Chanchaga consistently registering very high infection rates among both male and female populations. These high-burden LGAs formed a contiguous corridor of elevated HIV transmission concentrated in central and southeastern parts of the state. ART enrolment was similarly concentrated in these urban and peri-urban LGAs, indicating a positive correlation between disease burden and treatment access. In contrast, peripheral LGAs such as Borgu, Rijau, and Agwara exhibited low to moderate ART coverage and lower-case detection, highlighting structural gaps in healthcare access. Gender-based analysis revealed higher female prevalence in urban centers and lower male testing participation in rural LGAs, suggesting the influence of gender norms, stigma, and socio-economic barriers on service utilization. The distribution of HIV-negative results further confirmed disparities in testing coverage, with LGAs like Mokwa emerging as outliers with very high HIV-negative counts despite only moderate HIV-positive prevalence. The study concludes that HIV/AIDS in Niger State exhibits a strong spatial pattern influenced by urbanization, healthcare infrastructure, and socio-cultural dynamics. GIS-based analysis proved instrumental in identifying epidemiological hotspots, under-served areas, and testing gaps, offering a critical tool for spatial targeting of public health interventions. These findings advocate for a reorientation of HIV/AIDS control strategies to include spatial prioritization, equity-driven treatment distribution, and gender-responsive testing programs to advance toward universal health coverage and epidemic control.